SURGICAL-MANAGEMENT OF DISEASES OF THE STOMACH AND DUODENUM

The stomach, gastroesophageal junction, and duodenum are organs of com plex physiology and cell biology. Neoplastic disease of these organs i s a difficult surgical challenge, and mortality rates from gastric, du odenal, and distal esophageal cancer remain high despite advances in s urgical technique, perioperative care, and adjuvant therapy and more a ggressive surgical approaches. True ''cures'' elude the surgeon all to o frequently. Fortunately, our understanding of the genetics and molec ular biology of upper gastrointestinal neoplasms is increasing dramati cally and can now have a significant impact on the clinical management of these tumors as surgical therapies continue to improve. The care o f patients with benign disease of these organs is also evolving as med ical therapy and surgical technology improve to lessen the morbidity a ssociated with peptic ulcer disease, reflux disease, and morbid obesit y. This article reviews the most significant advances in surgical inte rvention of the stomach and duodenum published in the past year.